PPACA. Notwithstanding anything in this Agreement to the contrary, the waiver in respect of COBRA premiums pursuant to this Sections 5.1 and 5.2 shall cease to the extent required to avoid adverse consequences to the Company under the Patient Protection and Affordable Care Act of 2010 and regulations thereunder.
PPACA. To the extent that any post-termination continuation of health or medical coverage pursuant to this Agreement would violate either Section 105(h) of the Code or the Patient Protection and Affordable Care Act of 2010 (“PPACA”) and related regulations and guidance promulgated thereunder, the Employer may reform this Agreement in such manner as is reasonably necessary to provide the Employee with the intended benefit hereunder in a manner that complies with the PPACA; provided, however, that such reformation shall not result in a violation of Code Section 409A.
PPACA. The Patient Protection and Affordable Care Act of 2010, as amended from time to time, including regulations and guidance prescribed pursuant thereto.
PPACA. This article may be re-opened at the Board’s request to address PPACA rights, responsibilities and obligations and the impact of PPACA on the Board’s economic obligations, which shall not exceed the dollar amounts specified above.
PPACA. Patient Protection and Affordable Care Act. A Preferred Provider Organization (PPO) is a limited panel of Providers as designated by Alliant known. A Preferred Provider Organization (PPO) is a Provider that is included in a limited panel of Providers as designated by Alliant and for which the greatest benefit will be payable when one of these Providers is used. The amount required to pay for coverage. A drug which cannot be purchased except with a prescription from a Physician and which must be dispensed by a pharmacist. Primary Care Physician (PCP) A licensed family practice, general practice, pediatrics, non-specialized obstetricians and gynecologists, or internal medicine Physician who has entered into an agreement to coordinate the care of Members. A process used by Alliant to determine if a procedure or treatment is a medically necessary, covered service eligible under the plan for payment consideration. Prior Authorization approval is subject to all plan limits and exclusions. Any Physician, health care practitioner, pharmacy, supplier or facility, including, but not limited to, a Hospital, clinical laboratory, Ambulatory Surgery Center, Retail Health Clinic, Skilled Nursing Facility, Long Term Acute Care facility, or Home Health Care Agency holding all licenses required by law to provide health care services. A general hospital facility that provides Inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a Physician. Shall mean in Alliant’s discretion, services or supplies, which are necessary for the care and treatment of illness or injury not caused by the treating Provider. Determination that a service(s) is reasonable will be made by Alliant, taking into consideration unusual circumstances or complications requiring additional time, skill and experience in connection with a particular service or supply; industry standards and practices as they relate to similar scenarios; and the cause of injury or illness necessitating the service(s). This determination will consider, but will not be limited to, the findings and assessments of the following entities: (a) The National Medical Associations, Societies, and organizations; and (b) The Food and Drug Administration. To be Reasonable, service(s) and/or fee(s) must follow generally accepted billing practices for unbundling or multiple procedures. Services, supplies, care and/or treatment that results from errors in medical care...
PPACA. The term “PPACA” shall mean the Patient Protection and Affordable Care Act, as amended, and any regulations, rulings or other regulatory guidance issued with respect thereto.
PPACA. To the extent that any post-termination continuation of health or medical coverage pursuant to this Agreement would violate either (i) the Patient Protection and Affordable Care Act of 2010 (“PPACA”) and related regulations and guidance promulgated thereunder, or (ii) Section 105(h) of the Code and related regulations and guidance promulgated thereunder, the Company may reform this Agreement in such manner as is reasonably necessary to provide the Executive with the intended benefit hereunder in a manner that complies with the PPACA or Section 105(h) of the Code; provided, however, that such reformation shall not result in a violation of Code Section 409A and shall be applied in the same manner to all similarly-situated executives of the Company and, further provided, that the Company may discontinue some or all of the extended health or medical coverage if such coverage cannot be provided in any manner to the Executive without subjecting the Company and/or the Executive to penalty.
PPACA. The parties acknowledge that the Patient Protection and Affordable Care Act of 2010, as amended (PPACA), imposes a number of requirements and penalties related to health care plans and sponsors. Because the PPACA regulations are not yet issued in final form, and many questions remain with respect to eligibility, coverage, penalties and exchange rules, the Employer may request to open negotiations on health insurance matters covered under this Agreement that have been specifically impacted by the PPACA regulations and have been found to be in violation of the law or the PPACA regulations. Should the Employer decide to re-open negotiations, it will provide the other party thirty (30) days prior written notice of such intent.
PPACA. Patient Protection and Affordable Care Act. A Preferred Provider Organization (PPO) is a limited panel of Providers as designated by Alliant known. A Preferred Provider Organization (PPO) is a Provider that is included in a limited panel of Providers as designated by Alliant and for which the greatest benefit will be payable when one of these Providers is used. The amount required to pay for coverage. A drug which cannot be purchased except with a prescription from a Physician and which must be dispensed by a pharmacist. A licensed family practice, general practice, pediatrics, non- specialized obstetricians and gynecologists, or internal medicine Physician who has entered into an agreement to coordinate the care of Members. A process used by Alliant to determine if a procedure or treatment is a medically necessary, covered service eligible under the plan for payment consideration. Prior Authorization approval is subject to all plan limits and exclusions. Psychiatric Services within a General Hospital Facility A general hospital facility that provides Inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a Physician. Shall mean in Alliant’s discretion, services or supplies, which are necessary for the care and treatment of illness or injury not caused by the treating Provider. Determination that a service(s) is reasonable will be made by Alliant, taking into consideration unusual circumstances or complications requiring additional time, skill and experience in connection with a particular service or supply; industry standards and practices as they relate to similar scenarios; and the cause of injury or illness necessitating the service(s). This determination will consider, but will not be limited to, the findings and assessments of the following entities: (a) The National Medical Associations, Societies, and organizations; and (b) The Food and Drug Administration. To be Reasonable, service(s) and/or fee(s) must follow generally accepted billing practices for unbundling or multiple procedures. Services, supplies, care and/or treatment that results from errors in medical care that are clearly identifiable, preventable, and serious in their consequence for patients, are not Reasonable. Alliant retains discretionary authority to determine whether service(s) and/or fee(s) are Reasonable based upon information presented to Alliant. A finding of Provider negligence and/or malpractice is...
PPACA. Patient Protection and Affordable Care Act A limited panel of Providers as designated by Alliant known as a preferred provider organization. A Provider that is included in a limited panel of Providers as designated by Alliant and for which the greatest benefit will be payable when one of these Providers is used.
